Provider Demographics
NPI:1073514519
Name:MATNEY, MARTIN (ATC, PTA)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:MATNEY
Suffix:
Gender:M
Credentials:ATC, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11110 NE 100TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13120 NE 70TH PL
Practice Address - Street 2:SUITE 3
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8570
Practice Address - Country:US
Practice Address - Phone:425-889-0776
Practice Address - Fax:425-889-0857
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer